Ambetter Orientation Attestation

Ambetter from Sunflower Health Plan New Provider Orientation

All new Ambetter network providers are required to complete the Ambetter New Provider Orientation training.

Please review the recorded Ambetter New Provider Orientation training presentation. (Be sure sound is not on mute.)
Or view the Ambetter New Provider Orientation (PDF).
Then, complete the attestation form below to verify the training was completed.

Provider Group *

County *

Provider TIN (no dashes, please) *

TIN 2 Please provide any additional TINs that should be represented on this form. (No dashes, please.)

TIN 3

TIN 4

TIN 5

Phone Number *

Email Address *

Form Completed By *

Title *

Training Confirmation * Completed The Ambetter new provider orientation has been completed by the provider group above.